Melanoma Treatment May Prolong Life

Tuesday, October 17th 2000, 12:00 am
By: News On 6

HAMBURG, Germany (AP) — Adding an immune system booster to chemotherapy might double the chances of some advanced melanoma patients surviving the skin cancer, new research suggests.

Melanoma is one of the most rapidly increasing cancers in the world and has one of the worst prognoses if it is not caught early. There is currently no treatment that improves survival for people whose melanoma has spread to other parts of the body.

Whether they receive chemotherapy treatment or not, only about 10 percent of those whose disease has spread survive.

But using chemotherapy in combination with the immune stimulant interleukin-2 could push that up to 20 percent, researchers told scientists gathered Monday at a conference of the European Society for Medical Oncology in Hamburg.

The technique only helped those who, despite their cancer having spread to other organs, didn't yet feel sick, said the study's leader, Dr. Ulrich Keilholz. For those who already felt weak all over or were bedridden, it was probably too late to bolster the immune system, he said.

Boosting the immune system with interleukin-2 would not work early in the development of melanoma because microscopic single cancer cells are not enough to trigger an immune response, said Keilholz, professor of medicine at the Free University in Berlin.

Experts said Keilholz's findings were promising but preliminary and noted that the benefit the approach could provide seems limited. Scientists want to do better than 20 percent survival.

``It presents progress and it may turn out to be useful,'' said Dr. Huber Christoph, chairman of the oncology department at Johanes Gutenberg University in Mainz, Germany. ``But it's not enough. It's one step, but it's not going to be enough.''

``After more than 10 years of testing interleukin-2 we still don't know the optimal dose, and interleukin-2 can have side effects,'' he added.

At very high doses, interleukin-2 can result in a sharp drop in blood pressure, fever, chills and blood leaking into tissues. Keilholz said his team has not yet analyzed the side effects experienced by patients in the study.

Melanoma occurs when the skin's pigment cells become cancerous, most often after prolonged exposure to the sun. It is the deadliest of skin cancers, with some 90,000 new cases each year. It kills a total of 15,000 people every year in the United States, Europe and Australia.

It can be cured with surgery if it is caught when the tumor is thin and shallow. That happens in about 90 percent of cases.

For the rest — those with advanced melanoma — there is no standard treatment. Chemotherapy helps only about 15 percent of patients, and then only temporarily.

Keilholz's study involved 363 melanoma patients whose cancer had spread to other organs. Some had symptoms, such as feeling weak all over, while others felt fine.

They were all given the chemotherapy drugs DTIC and cisplatin, as well as the protein interferon-alpha for four treatment cycles. About half were also given injections of interleukin-2.

When all patients were taken together, interleukin didn't improve survival. But Keilholz found that was largely because there were many patients included who already felt sick.

When they were excluded, 195 people were left in the study and those given the immune booster tended to have a survival advantage.

Two years after starting treatment, 20 percent of those in the experimental group were still alive, compared with 10 percent in the other group.

``This is still meaningful because once you are out to two years, your chances are high you will have a stable remission,'' Keilholz said. ``It's a small number of patients surviving, but it's still a step to move that upward.''